Provider Demographics
NPI:1144271701
Name:SYMMONDS, BREAN MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:BREAN
Middle Name:MICHELLE
Last Name:SYMMONDS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10160 W. 50TH AVENUE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033
Mailing Address - Country:US
Mailing Address - Phone:720-542-3260
Mailing Address - Fax:720-328-5264
Practice Address - Street 1:10160 W. 50TH AVENUE
Practice Address - Street 2:SUITE 4
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033
Practice Address - Country:US
Practice Address - Phone:720-542-3260
Practice Address - Fax:720-328-5264
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002266A111N00000X
CO6560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor